Student's Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Gender *

Male

Female

Parent / Guardian Name *

First Name

Last Name

Parent / Guardian Phone Number *

(###)

###

####

I will follow the rules of conduct and directions given to me by any of the adult leaders of this event. I understand that if I choose not to follow the rules of conduct, and/or directions given to me by any leader of this event, I will be sent home without a refund. If I bring or participate in any illegal activity (drugs/ alcohol) I understand that the police will be called first, then my parents will be notified. *

I understand

I do not understand